OSCAR expert needed - out of things to try....

[Gideon]

I am seeing a good number of flow limits that are not being caught and resulting in arousal. Your last zoom is a good example of this.
Typically a 3-minute view will provide the appropriate length zoom except for a few circumstances.

Can you include/import your ring data so we can see it along with your OSCAR data. No issue with your leaks. so move up your FL and SO2 charts. Limit the Flow rate chart to +/- 75 on the vertical scale.

What other than apnea do you have going on? It is possible that you will find a BiLevel (VAuto) better for you and I'd start that with a min EPAP of 4 and a PS of 4 which should help some. As you know your numbers don't indicate this. Also an indicated O2 Desat of 90 MAYBE, not will, be significant for you. So do include the full report from your ring.

[pezhead99]

awesome, thanks. can we get a snapshot of the 16 minute chunk of the latest post between 23:19 to 23:35?  I know this shows alot of non-sleep and finally a transition to sleep.

QAL

Is this what you are looking for?

[pezhead99]

The second detail shot shows a 1 minute chunk at 23:38.
1. the first 5 breaths, longish pause, and the sixth one at 23:38:35 are all indicative of sleep breathing. I found it interesting that after the long pause, (a.) you were still asleep, and (b.) the breath was the same intensity as the preceding ones, almost as if your body was in "i don't care" mode.  Usually, after a longer pause the body get's a strong urge to get more oxygen and so there is a more intense recovery breath, probably accompanied by a wakening.
2. the alerting happened after the sixth breath, and the remaining breaths are now indicating the brain is processing and forcing the issue, you may not think you are awake, but the brain is now calling the shots, and demands larger breaths and the exhale is halted several times as if you would if you winced (pain?) and spurted parts of the pent up breath volume (large inhale - hold - partial exhale - hold - partial exhale - hold - more exhale.)

This may not be characteristic of any normal night.

QAL

This is very interesting. Here's a few more detail shots -- more of the same?

[pezhead99]

I am seeing a good number of flow limits that are not being caught and resulting in arousal. Your last zoom is a good example of this.  
Typically a 3-minute view will provide the appropriate length zoom except for a few circumstances.  

Can you include/import your ring data so we can see it along with your OSCAR data.  No issue with your leaks. so move up your FL and SO2 charts.  Limit the Flow rate chart to +/- 75 on the vertical scale.

What other than apnea do you have going on?  It is possible that you will find a BiLevel (VAuto) better for you and I'd start that with a min EPAP of 4 and a PS of 4 which should help some.  As you know your numbers don't indicate this.  Also an indicated O2 Desat of 90 MAYBE, not will, be significant for you.  So do include the full report from your ring.

Thanks Gideon! Can you explain what you mean by "a good number of flow limits not being caught and resulting in arousal" - what does this look like and what is the impact?

I tried to import my O2ring data but I was having trouble because many nights the ring records are split into multiple readings for some reason, making time syncing difficult.

[Gideon]

It is rare with Sleep Apnea to have Oxygen controlling our breathing. Typically it is our need to remove CO2 and its byproducts. Do a dive in to our respiratory cycle and its drivers.

I find 1-minute views do not usually provide enough info around events to fully see what is going on. I do see flow limits leading into breath holding indicating a possible arousal but usually not enough after the event to see if wake breathing happens.

[pezhead99]

It is rare with Sleep Apnea to have Oxygen controlling our breathing.  Typically it is our need to remove CO2 and its byproducts.  Do a dive in to our respiratory cycle and its drivers.

I find 1-minute views do not usually provide enough info around events to fully see what is going on.  I do see flow limits leading into breath holding indicating a possible arousal but usually not enough after the event to see if wake breathing happens.

Got it. Here's a 3-minute detail - let me know if this shows anything helpful. Really appreciate your expertise!

[quiescence at last]

This is very interesting. Here's a few more detail shots -- more of the same?

in this case both snaps are suggestive of sleeping only.

QAL

[pezhead99]

Thanks - how should I interpret that?

[quiescence at last]

ph99, when the machine starts up but does not raise the pressure, the machine does not recognize that you have fallen asleep.  the machine finally believes you are asleep at about 23:32:30.  I asked for the 16 minute long snap when you (supposedly) were transitioning to sleep.  I thought I would see and could note the point in the flow graph when you changed the style of breathing.  However, I do not see a distinct pattern of transition from awake breathing to sleep breathing. sorry. not sure what to make of that.

So, next thing I want to try is looking at a 10 minute clip from about 23:42 to 23:52. This period seems to be mostly sleep, and we would just look at the regularity (or irregularity) of breathing while sleeping. The first part is the OA and what immediately preceded it.

QAL

[pezhead99]

ph99, when the machine starts up but does not raise the pressure, the machine does not recognize that you have fallen asleep.  the machine finally believes you are asleep at about 23:32:30.  I asked for the 16 minute long snap when you (supposedly) were transitioning to sleep.  I thought I would see and could note the point in the flow graph when you changed the style of breathing.  However, I do not see a distinct pattern of transition from awake breathing to sleep breathing. sorry. not sure what to make of that.

So, next thing I want to try is looking at a 10 minute clip from about 23:42 to 23:52. This period seems to be mostly sleep, and we would just look at the regularity (or irregularity) of breathing while sleeping. The first part is the OA and what immediately preceded it.

QAL

QAL, here you go - thanks!